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. 2020 May 22;10:8507. doi: 10.1038/s41598-020-65503-1

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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(a) The lacrimal gland and the salivary gland share the same parasympathetic innervation originating in the brainstem yielding a common connection for the transmission of aSyn pathology. Tear fluid was collected using Schirmer strips. aSyn levels were quantified applying single molecule array (SIMOA) (b) aSyn tear fluid levels in PD/CTR (p = 0.03). (c) aSyn levels in PD stratified by Hoehn & Yahr stage (HY) and in atypical Parkinsonian (aPS) syndromes stratified by tauopathies (Tau) and synucleinopathies (Syn). (d) ROC curve for the discrimination of PD and CTR. (e) Correlation between aSyn and UPDRS III. Data in (b,c) is presented as single values with median and interquartile range on a log10 scaled y-axis. PD = Parkinson’s disease, CTR = control subjects.